Orthodontic appliance

ABSTRACT

A removable orthodontic appliance that exerts corrective forces on teeth incorporates a timing system which records the amount of time the appliance has been used by the patient to enhance patient treatment.

United States Patent 1191 Northcutt May 27, 1975 ORTHODONTIC APPLIANCE 3,019,658 2/1962 Ehrhart 73/432 R 3,303,566 2 1967 W' k1 32 14 D [76] inventor: Michael Nmhcm, 1704 3,337,958 8/1967 sti r ler f 32/14 1) Mlramonle Mount VIEW, Cahf- 3,533,163 10/1970 Kirschenbaum 32/14 D 94040 3,563,231 2/1971 Ducote 128/2.1 M Filed: June 1973 3,648,372 3/1972 Klrschenbaum 32/14 D [21] Appl. No.: 370,445

Primary Examiner-L0u1s G. Mancene Related Appllcatlon Data Assistant Examiner.1. Q. Lever [63] Continuation-impart of Ser. No. 302,734, Nov. 1,

1972, abandoned.

52 US. Cl. 32/14 D; 128/21 M [57] ABSTRACT [51] Int. Cl. A616 7/00 58 Field of Search 32/14 R, 14 D, 14 E, 14 A; mfmvable apphan w? 128/21 73/432 R we orces on teet mcorpdrates a tlmlng system whlch records the amount of tlme the apphance has 5 6] References Cited been used by the pat1ent to enhance patlent treatment. UNITED STATES PATENTS 18 Claims, 9 Drawing Figures 2,318,001 5/1943 Linde 32/14 E PATENTEB 2 75 SHEET 03 SF,

FIGB

ORTHODONTIC APPLIANCE RELATED APPLICATIONS This application is a continuation-in-part of application Ser. No. 302,734 filed Nov. 1, 1972, now abandoned. I

This invention relates to removable orthodontic appliances that exert corrective forces on teeth.

The use of removable appliances that exert corrective forces on teeth such as headgears, mono-blocks, activators, crozats, retainers, spring loaded retainers and the like is at the discretion of the patient who most often is an adolescent. Since the appliance may be somewhat uncomfortable and inconvenient to wear, it takes considerable will power to adhere to a treatment program. It can be particularly difficult to adhere to a program for an adolescent who may not fully recognize the true value of the treatment.

The rate of corrective movement of teeth is a function both of the forces applied to the teeth and the time those forces have been applied. Failure to wear an appliance for the prescribed periods results in reduced corrective movement of the teeth and, in addition, such failure can result in the use of incorrect forces in later stages of the treatment. As treatment progresses, forces are often determined in relation to the effectiveness of forces used in earlier stages. If a patient represents that the program has been fully complied with when in fact it has not, the orthodontist is led to believe that the forces applied earlier were inadequate to cause the desired rate of tooth movement. As a consequence, excessive forces may be chosen which can work to the detriment of the patient.

It is a primary object of the present invention to overcome the lack of proper use of an appliance by recording the time the appliance has been in use.

In accordance with the present invention there is provided a removable orthodontic appliance that exerts corrective forces on teeth, said appliance having means for sensing and recording the amount of time the appliance is in use on the patient.

Recording the amount of time the appliance has been used by the patient not only facilitates control of the case by the orthodontist and permits early detection of poor cooperation by the patient, but this information also acts as a psychological inducement to the patient. Logging in the hours is much like watching weight loss; each hour recorded is an inducement to stick with it.

The recording means employed in the practice of this invention can be any of a variety of means known in the art. It can be a small or miniaturized electronic instrument, including those on metal oxide semiconductor chips, it can be a charging or discharging cell; it can be a small clock; or it can be any other form desired. The recording means may be supported by or incorporated into any desirable part of the structure of the appliance; while the recording means can, if desired, provide a direct visual readout, in a preferred embodiment on the invention, the recorder does not provide a direct visual readout but is connected to a readout device to determine the amount of time the patient has used the headgear. This minimizes tampering with the recorder by the patient.

For those recorders that require power, a miniaturized battery or the like may beemployed and, indeed, the electrolytic activity of the mouth may be utilized to charge a micro circuit or the spring energy of a headgear may be used. The selection of an appropriate power source is within the skill of the routineer.

A variety of sensing means may also be employed to actuate the recording means. Means responsive to forces developed by the appliance; means responsive to body heat such as a thermistor; means responsive to capacitance, resistance or other attributes of skin electrolytic functions; means responsive to fluids in the mouth; or any other desired means may be employed. Each of the above described sensing means, as well as others, is within the skill of the art. It will be understood that the sensing and recording means may be suitably packaged to protect them from shock, mouth fluids or the like depending on their location.

In one aspect this invention contemplates that force sensing means actuated only Within a limited range of forces be employed. This can be effective to prevent an effort to create a false record by applying forces to the applicance when it is not in actual use by the patient. In another aspect, this invention contemplates that two attributes be employed to actuate the recording means. For example, temperature and pressure, pressure and conductance, temperature and conductance, pressure and resistance, temperature and resistance, or the like maybe employed to actuate the recording means so that the device will be essentially fool proof. Since the patient would be unaware of which attributes were used, it would be extremely difficult to effect a false reading.

The practice of this invention will be described in detail with respect to a headgear as shown in FIGS. 1-9 of the attached drawings.

FIG. 1 is a bottom plan view of a headgear constructed in accordance with one embodiment of the present invention and shows the headgear operatively associated with the upper arch of a patients mouth;

FIG. 2 is a fragmentary side elevation view taken along the line and in the direction indicated by the arrows 22 in FIG. 1 and shows an adjustment mechanism at one end of the inner bow of the headgear shown in FIG. 1;

FIG. 3 is a fragmentary front elevation view taken along the line and in the direction indicated by the arrows 33 in FIG. 1 and shows a coil spring in the outer bow of the headgear illustrated in FIG. 1;

FIG. 4 is a fragmentary elevation taken along the line and in the direction of the arrows 4-4 in FIG. 1 and shows a time recorder in the head pad for recording the amount of time the headgear is in use by the patient;

FIG. 5 is a fragmentary elevation view like FIG. 4 and shows a clock in the head pad for recording the amount of time the headgear is in use by the patient;

FIG. 6 is an isometric view of the recording instrument incorporated in the headgear as shown in FIG. 4 and its association with a readout instrument plugged into the recording instrument in the orthodontists office;

FIG. 7 is a diagram illustrating circuit details of the recording instrument shown in. FIG. 4;

FIG. 8 is a diagram showing details of the circuitry of the readout instrument or office monitor used in the or thodontists office and shown in FIG. 6; and

FIG. 9 is a pictorial view showing how readout is taken in the orthodontists office.

Referring to FIG. I, the headgear 10 includes an inner bow or frame 12 and an outer bow or frame 14. A bracket 16 is attached to an upper molar 17 as illustrated in FIG. 1, and an end piece 19 of the inner bow or frame 12 slides into a tube 21 on a bracket 16 until an offset face 23 of the end piece 19 abuts the end of the tube 21. The outer bow 14 is connected to the inner bow 12 at the forward end of the inner bow as indicated by the reference numeral 18. As shown in FIG. 1, coil springs 26 may be incorporated in the outer bow at the areas of attachment to the inner bow. These coil springs permit both lateral and longitudinal displacement of the ends of the outer bow to provide cushioning and shock absorption. These coil springs make the headgear more pliable as is required when a patient sleeps with the side of his face on the pillow.

The ends of the outer bow 14 extend outward alongside the sides of the patients head, and an elastic band 20 is connected to the ends of the outer bow by the hook-on connectors 22. The elastic band 20 includes a pad 24 which is engaged with the back of the patients head or neck. The band is stretched when the pad 24 is engaged with the back of the patients head or neck, and this exerts a tension force on the outer bow 14. This tension force is transmitted to the inner bow 12 as the compression force in the inner bow. The shoulders 23 on the rods 19 of the inner bow engage the ends of the tubes 21 of the brackets 16 to exert a retraction force on the molars 17.

The end portions of the inner bow include adjustment means for adjusting the bow with respect to the brackets 16 to adjust the spacing between the inner bow and the front teeth. The adjustment means 30 include an inner rod or tube 32 which is fixed to the rod 19 and an outer sleeve or tube 34 which is connected to or integral with the inner bow 12. As shown in FIG. 2 a set screw 36 may be used to retain the parts 32 and 34 in the adjusted position. Other means, such as crimping the parts or threads between the parts, may equally well be used.

As shown in FIG. 5, a recorder means such as a clock 40 is attached to the pad 24. The clock 40 is actuated to record by a switch connected to the tension band 20. When the band is stretched in the course of being placed on the patients head, the tension closes the switch to start the clock 40. Such switch mechanisms are currently common to stop watches.

Another form of time recorder for recording the amount of time that the headgear is used by the patient is shown in FIGS. 4, 6, 7, and 8. In this case the time recorder is an electronic instrument 42.

As illustrated in FIG. 4 the recorder 42 is incorporated in the headgear between the ends of the tension band 20 so as to be actuated by stretching of the band. However, the recorder 42 may also be located elsewhere such as at the front of the inner bow 12 between the points of connection 18 to the outer bow 14. In either case the recorder 42 is a monolithic integrated CMOS chip which is actuated to record by sensing means responsive to the retraction force produced when the headgear is installed. When mounted in the headband, the sensing means comprises a switch associated with the band 20. When the recorder is mounted in the bow structure, the sensing means may comprise a switch associated with one of the springs 26 or associated with the bracket tube 21 and the surface 23 of the rod at the end of the inner bow.

As illustrated in FIGS. 4 and 7 the recorder 42 may include force setting means 43 for selecting a limited range of forces for actuating the recorder. This may be done by inserting a key in a slot or by other means. Selecting a limited range of forces tends to minimize tampering. If the force must be very close to that which exists when the headgear is installed, it is difficult for the patient to duplicate that amount of force by stretching the band without installing the headgear.

The recorder 42 preferably does not visually indicate the amount of the time recorded on the recorder. Instead, the recorder 42 includes connector sockets A and B for connection to corresponding connector pins A and B of a readout instrument 48 as illustrated in FIG. 6. The readout instrument or office monitor 48, when plugged into the recorder 42, indicates the amount of time recorded, and thus the amount of time the headgear has been in use by the patient. This minimizes tampering by the patient.

FIGS. 7 and 8 shows details of the circuitry for the recorder 42 and the monitor 48. The headgear 42 comprises one monolithic integrated CMOS chip 50. The chip 50 includes an oscillator 52, a divider 54, and a buffer 56. A tension operated microswitch 44, the force setting means 43, and a quartz crystal 58 are connected to the oscillator 52. A mercury battery 60 is connected to the divider 54. Six binary outputs 62 from the buffer 56 count from 0 to 63 days. A reset button 64 is connected to the divider 54.

The office monitor 48 includes a two digit LED (light emitting diodes) display screen 66. The display screen is connected to a standard TTL integrated circuit decoder 68. Six binary inputs are connected to the decoder 68 and are also connectable to the binary outputs 62 of the recorder. A reset button 72 is connected to the decoder 68. A power supply 74 is connected to the display screen 66. An on/off switch 76 is connected between the power supply 74 and the mains.

FIG. 9 is a pictorial view showing how readout is taken from the overall system in the orthodontists offree. In FIG. 9 a single coaxial outlet A and a related coaxial plug A are used instead of the two sockets and two connector pins shown in FIG. 6.

While the clock 40 and electronic recorder 42 have been illustrated and described, other recorder means may be used as noted earlier.

In addition to a timer, this invention also contemplates that the removable orthodontic appliance may be equipped with other features. A headgear appliance may include, for example, a pressure indicator or recorder including strain gauges, and transducers. Pressure indicators or recorders for headgears are known in the art and are described, inter alia, in US. Pat. Nos. 3,533,163, 3,648,372 and 3,526,035. A headgear appliance may also, if desired, include a radio with or without an earpiece so that use of the headgear will be rendered more attractive.

The disclosures and the description herein are purely illustrative and are not intended to be in any sense limiting. Since variations of the invention will be apparent to those skilled in the art, it is intended that this invention be limited only by the scope of the appended claims.

I claim:

1. A removable orthodontic appliance comprising means for exerting corrective forces on teeth, said appliance also including means for sensing when the appliance is being used and means responsive to said sensing means for recording the amount of time the appliance is in use on the patient.

2. The appliance of claim 1 wherein the sensing means are responsive to forces exerted by the appliance.

3. The appliance of claim 1 wherein the sensing means are responsive to a skin electrolytic function.

4. The appliance ofclaim 1 wherein the recorder provides a direct readout.

5. The appliance of claim 1 wherein the recorder must be connected to a readout instrument to provide a readout.

6. A removable orthodontic traction appliance of the kind used in orthodontia for retracting the upper teeth of a patient, said appliance comprising frame means for engaging brackets attached to upper molars to exert a force on the molars, said appliance also including means for sensing when the appliance is being used and means responsive to said sensing means for recording the amount of time the appliance is in use on the patient.

7. The appliance as defined in claim 6 wherein the appliance includes a bow structure and the recorder means are located in the bow structure.

8. The appliance as defined in claim 6 wherein the appliance includes a head pad and the recorder means are located in the head pad.

9. An appliance as defined in claim 6 wherein the sensing means are responsive to the force exerted by the frame means.

10. An appliance as defined in claim 6 wherein the sensing means include force setting means effective to select a limited range of forces for actuating the recorder.

11. An appliance as defined in claim 6 wherein the recorder records the time of use but does not display the amount of time recorded.

12. An appliance as defined in claim 6 including a pressure indicator or recorder.

13. A pad of the kind associated with an elastic band for applying a load to bow structure of an orthodontic traction appliance, said pad including means for sensing when said appliance is being used and means responsive to said sensing means for recording the amount of time the appliance is in use.

14. A pad as defined in claim 13 wherein the pad is shaped to engage the back of the patient's neck.

15. A pad as defined in claim 13 wherein the recorder includes a solid state memory chip and the sensing means includes switch means which are closed in response to a force within a selected range of forces and a temperature within a selected range of temperatures so that the recorder will not record unless both conditions of force and temperature are present.

16. A readout instrument in combination with the orthodontic appliance of claim 1.

17. A method of correcting the position of teeth of a patient with a removable orthodontic appliance comprising exerting corrective forces on said teeth with said removable appliance, sensing when the appliance is being used with sensing means on said appliance and recording the time said appliance is used by the patient with recorder means on said appliance, said recording means being responsive to said sensing means.

18. According to claim 17 including engaging a metal frame against brackets attached to upper molars, exerting a force on the metal frame to retract the upper teeth, and recording on a time recorder built into the appliance the amount of time the metal frame is so engaged under force with the brackets. 

1. A removable orthodontic appliance comprising means for exerting corrective forces on teeth, said appliance also including means for sensing when the appliance is being used and means responsive to said sensing means for recording the amount of time the appliance is in use on the patient.
 2. The appliance of claim 1 wherein the sensing means are responsive to forces exerted by the appliance.
 3. The appliance of claim 1 wherein the sensing means are responsive to a skin electrolytic function.
 4. The appliance of claim 1 wherein the recorder provides a direct readout.
 5. The appliance of claim 1 wherein the recorder must be connected to a readout instrument to provide a readout.
 6. A removable orthodontic traction appliance of the kind used in orthodontia for retracting the upper teeth of a patient, said appliance comprising frame means for engaging brackets attached to upper molars to exert a force on the molars, said appliance also including means for sensing when the appliance is being used and means responsive to said sensing means for recording the amount of time the appliance is in use on the patient.
 7. The appliance as defined in claim 6 wherein the appliance includes a bow structure and the recorder means are located in the bow structure.
 8. The appliance as defined in claim 6 wherein the appliance includes a head pad and the recorder means are located in the head pad.
 9. An appliance as defined in claim 6 wherein the sensing means are responsive to the force exerted by the frame means.
 10. An appliance as defined in claim 6 wherein the sensing means include force setting means effective to select a limited range of forces for Actuating the recorder.
 11. An appliance as defined in claim 6 wherein the recorder records the time of use but does not display the amount of time recorded.
 12. An appliance as defined in claim 6 including a pressure indicator or recorder.
 13. A pad of the kind associated with an elastic band for applying a load to bow structure of an orthodontic traction appliance, said pad including means for sensing when said appliance is being used and means responsive to said sensing means for recording the amount of time the appliance is in use.
 14. A pad as defined in claim 13 wherein the pad is shaped to engage the back of the patient''s neck.
 15. A pad as defined in claim 13 wherein the recorder includes a solid state memory chip and the sensing means includes switch means which are closed in response to a force within a selected range of forces and a temperature within a selected range of temperatures so that the recorder will not record unless both conditions of force and temperature are present.
 16. A readout instrument in combination with the orthodontic appliance of claim
 1. 17. A method of correcting the position of teeth of a patient with a removable orthodontic appliance comprising exerting corrective forces on said teeth with said removable appliance, sensing when the appliance is being used with sensing means on said appliance and recording the time said appliance is used by the patient with recorder means on said appliance, said recording means being responsive to said sensing means.
 18. According to claim 17 including engaging a metal frame against brackets attached to upper molars, exerting a force on the metal frame to retract the upper teeth, and recording on a time recorder built into the appliance the amount of time the metal frame is so engaged under force with the brackets. 